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Master Thesis

Impact pronostique de la survenue d’un embole dans l’artère cérébrale antérieure au cours de la thrombectomie mécanique

Abstract : Objective: To identify the incidence, the clinical outcomes and predictors of anterior cerebral artery emboli (ACAE) in previously unaffected territory occurring during mechanical thrombectomy. Methods: We retrospectively reviewed, in a prospectively collected database, consecutive patients with anterior circulation stroke between January 2012 and December 2016. Angiographic images were analyzed to assess ACAE. The primary outcome was the favorable outcome defined as a 3-months modified Rankin Scale (mRS) of 0–2. Results: Among 690 included patients, ACAE occurred in 65 patients (9.4%; 95%CI, 7.2 to 11.6%). ICA occlusion (tandem or terminal), ASPECTS<7, increasing number of passes and use of SR alone (compared to distal aspiration alone or combined technique) were found as independent predictors of ACAE. Compared to patients without ACAE, patients with ACAE have a lower efficacy outcome rates, with an adjusted OR (95%CI) of 0.48 (0.25 to 0.92) for favorable outcome, 0.53 (0.28 to 1.00) for successful perfusion, 0.27 (0.12 to 0.56) for complete reperfusion and 0.49 (0.25 to 0.96) for early neurologic improvement. ACAE was significantly associated with a higher mortality (adjusted OR, 1.93; 95%CI, 1.03 to 3.61) and intracranial hemorrhage complication (adjusted OR, 2.45; 95%CI, 1.33 to 4.47). Conclusions: Procedural ACAE was not an uncommon condition, which was associated with increased mortality and disability rates.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02476023
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Vanessa Chalumeau. Impact pronostique de la survenue d’un embole dans l’artère cérébrale antérieure au cours de la thrombectomie mécanique. Médecine humaine et pathologie. 2017. ⟨dumas-02476023⟩

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